TSR: A User-Friendly R Shiny Application for Assessment of Optimal Blood Product Selection in ABO-Incompatible Hematopoietic Stem Cell Transplantation

Abstract

Objective

Patients undergoing hematopoietic stem cell transplant (HSCT) need frequent transfusions, until their red blood cells (RBCs) and platelets start to recover. The safe transfusion for patients who receive ABO-incompatible HSCT is essential to the transplant process. To date, there is no user-friendly tool to choose the right blood product for transfusion treatment, despite the number of guidelines and expert advice on the subject.

Methods

R/shiny is a powerful programming language for clinical data analysis and visualization. It can create interactive web applications that work in real-time. The web application named TSR was built using R programming, simplifying blood transfusion practice for ABO-incompatible HSCT with a one-click solution.

Results

The TSR is divided into four main tabs. The home tab provides an overview of the application, while RBC, plasma and platelet transfusion tabs offer tailored suggestions for blood product selection in each category. Unlike traditional methods that rely on treatment guidelines and specialist consensus, TSR leverages the power of the R/Shiny interface to extract critical content based on user-specified parameters, providing an innovative approach to improve transfusion support.

Conclusion

The present study highlights that the TSR enables real-time analysis, and promotes transfusion practice by offering a unique and efficient one-key output for blood product selection to ABO-incompatible HSCT. TSR has the potential to become a widely-utilized tool for transfusion services, providing a reliable and user-friendly solution that enhances transfusion safety in clinical practice.

Keywords

transfusion practice / peripheral blood stem cell transplant / transfusion risks

References

[1] ChabannonC, KuballJ, BondanzaA, et al.. Hematopoietic stem cell transplantation in its 60s: A platform for cellular therapies. Sci Transl Med, 2018, 10(436): eaap9630

[2] PetersdorfEW. Genetics of graft-versus-host disease: the major histocompatibility complex. Blood Rev, 2013, 27(1): 1-12

[3] TiercyJM. How to select the best available related or unrelated donor of hematopoietic stem cells?. Haematologica, 2016, 101(6): 680-687

[4] RydbergL. ABO-incompatibility in solid organ transplantation. Transfus Med, 2001, 11(4): 325-342

[5] WorelN. ABO-Mismatched Allogeneic Hematopoietic Stem Cell Transplantation. Transfus Med Hemother, 2016, 43(1): 3-12

[6] KopkoPM. Transfusion Support for ABO-Incompatible Progenitor Cell Transplantation. Transfus Med Hemother, 2016, 43(1): 13-18

[7] BoothGS, GehrieEA, BolanCD, et al.. Clinical guide to ABO-incompatible allogeneic stem cell transplantation. Biol Blood Marrow Transplant, 2013, 19(8): 1152-1158

[8] O’DonghaileD, KelleyW, KleinHG, et al.. Recommendations for transfusion in ABO-incompatible hematopoietic stem cell transplantation. Transfusion, 2012, 52(2): 456-458

[9] ZhangZ. Data management by using R: big data clinical research series. Ann Transl Med, 2015, 3(20): 303

[10] PinaA, MacedoMP, HenriquesR. Clustering Clinical Data in R. Methods Mol Biol, 2020, 2051: 309-343

[11] JiaL, YaoW, JiangY, et al.. Development of interactive biological web applications with R/Shiny. Brief Bioinform, 2022, 23(1): bbab415

[12] CohnCS. Transfusion support issues in hematopoietic stem cell transplantation. Cancer Control, 2015, 22(1): 52-59

[13] DutcherJP. Transfusion Therapy: Clinical Principles and Practice. Ann Intern Med, 2000, 133(7): 572

[14] StorchEK, CusterBS, JacobsMR, et al.. Review of current transfusion therapy and blood banking practices. Blood Rev, 2019, 38: 100593

[15] EngelbrechtS, WoodEM, Cole-SinclairMF. Clinical transfusion practice update: haemovigilance, complications, patient blood management and national standards. Med J Aust, 2013, 199(6): 397-401